Tricuspid Annular Plane Systolic Excursion (TAPSE) in Dogs: Reference Values and Impact of Pulmonary Hypertension

Abstract

Background: The impact of pulmonary hypertension (PH) on right ventricular systolic function is difficult to assess. Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic measurement of right ventricular systolic function and a strong predictor of outcome in human PH patients.Hypothesis/Objectives: Determine a reference range for TAPSE in healthy dogs, and quantify TAPSE in dogs with PH. It is hypothesized that TAPSE is lower in dogs with PH compared with a reference group, and decreases as PH worsens.Animals: Fifty normal dogs and 30 dogs with PH. Methods: TAPSE was measured by 2-dimensional echocardiography-guided M-mode from the left apical 4-chamber view. Peak systolic tricuspid valve regurgitation jet velocity was measured by continuous-wave Doppler to estimate right ventricular-to-right atrial pressure gradient. PH was subjectively classified as mild, moderate, and severe.Results: There was a curvilinear correlation between TAPSE and body weight. The upper and lower limits of the 95% reference interval were determined by quantile regression. Interobserver and intraobserver agreement was adequate with a coefficient of variation <10%. There were significant differences when comparing dogs with PH and the healthy group, as well as between the PH subgroups (P < .01), except between dogs with mild and moderate PH (P = .99). Only dogs in the severe PH group had TAPSE values that were mostly below the lower limit of the reference interval.Conclusions and Clinical Importance: TAPSE is easily obtainable with acceptable inter and intraobserver agreement. TAPSE is decreased in PH and below the reference interval in most dogs with severe PH.

Prognostic Significance of Exercise-induced Right Ventricular Dysfunction in Asymptomatic Degenerative Mitral Regurgitation

“…Tricuspid excursion has been previously reported to have good predictive value for RV failure, 21 and it is simple and easy to measure this value during exercise. 11,22 In the present study, several parameters of resting RV function proved to be predictors of events including RV chamber size (RV end-diastolic and endsystolic area) and RV systolic function (RVFAC, RV strain, and TAPSE). More importantly, exercise RV dysfunction had additional value in the prediction of time until surgery in asymptomatic MR. A recent study reported that exercise SPAP was more accurate than resting SPAP for predicting the occurrence of symptoms in patients with asymptomatic MR. 5 Our results are consistent with this previous work that links exercise SPAP with poor prognosis in asymptomatic degenerative MR, but in our study, we also evaluated the contribution of exercise RV systolic function and exercise PAH.…”

Tricuspid valve dysplasia in a domestic feline: case report

“…Tricuspid annular plane systolic excursion is an echocardiographic index used to evaluate the RV systolic function, which is measured by apical displacement of the lateral portion of the tricuspid valve annulus during systole, in the M-mode (PARIAUT et al, 2012). The measured value of TAPSE was 2.56 mm, which is below the value reported in the literature for Maine Coon cats (8.70 to 10.70 mm) (ITIKAWA et al, 2012).…”

Echocardiographic assessment of right ventricular systolic function in conscious healthy dogs following a single dose of pimobendan versus atenolol

“…It is, however, another angledependent, region-specific index that may be adversely affected by translational motion. A recent study 32 revealed that TAPSE is decreased in dogs with varying severities of pulmonary hypertension and below the reference interval in most dogs with severe pulmonary hypertension. TAPSE has been validated in healthy people 33 and has been shown to correlate well with radionuclide- 34 and CMR-derived RV EF 35 in people with RV dysfunction.…”